Employment Application - Gulf Harbour Yacht and Country Club

About You

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone Number:

Other Number:

Have you previously worked for this Company?

Yes

No

If Yes, when?

Do you have relatives or friends presently working for this Company?

Yes

No

If Yes, who?

Were you referred for employment?

Yes

No

If Yes, who referred you?

Are you 18 years of age or over?

Yes

No

Do you smoke?

Yes

No

If you are not over the age of 18, employment is subject to verification that you are of legal minimum legal age and can furnish any required work permit.

Job Interest/Availability

Position(s) Desired:

Hours:

Full-Time

Part-Time

Temporary

Hours/days per week desired:

Hours/days per week you are not available for work:

Are you able to work weekends and/or holidays?

Are you able to work overtime when needed?

Salary Requirements:

Date you will be available to begin work:

High School Education

Select Highest Grade Completed

High School Name:

Did you graduate?

Yes

No

If Yes, Date?

Receive G.E.D?

Yes

No

If Yes, Date?

From:

To:

College or University

Name

City:

State:

To:

From:

Field of Study:

Type of Degree Obtained:

Date Obtained:

Other School or Training

Other Education or Training:

Name of Facility:

City:

State:

To:

From:

Drivers License

A good driving record is required for some positions. All applicants must provide this information.

License No.:

State:

Expiration:

Employment History

List all employers for the past five years, including Military Service. During the last five years also include any gaps in employment and any instances you provided services as an independent contractor (Ask for an additional form if necessary).

If you were ever employed by a different name please provide that name here:

Employment History 1

Employer:

Supervisor:

Address:

City:

State:

Zip:

Phone

Position Held:

To:

From:

Salary:

Duties:

Reason for Leaving:

May We Contact?

Yes

No

Employment History 2

Employer:

Supervisor:

Address:

City:

State:

Zip:

Phone

Position Held:

To:

From:

Salary:

Duties:

Reason for Leaving:

May We Contact?

Yes

No

Employment History 3

Employer:

Supervisor:

Address:

City:

State:

Zip:

Phone

Position Held:

To:

From:

Salary:

Duties:

Reason for Leaving:

May We Contact?

Yes

No

Employment History 4

Employer:

Supervisor:

Address:

City:

State:

Zip:

Phone

Position Held:

To:

From:

Salary:

Duties:

Reason for Leaving:

May We Contact?

Yes

No

Personal Reference 1

Include persons other than relatives and employers.

Name

Occupation:

Years Known:

Address:

Phone

Personal Reference 2

Include persons other than relatives and employers.

Name

Occupation:

Years Known:

Address:

Phone

Qualifications

Are you legally eligible for employment in the U.S.?

Yes

No

You will be required to provide proof of employment eligibility and identity after an offer of employment is made to you upon the commencement of your employment.

Have you ever been convicted of a crime, entered a plea of nolo contendere (no contest) to a crime or received a suspended sentence (regardless of the ultimate adjudication) for a crime?

Yes

No

If Yes, please explain:

Have you ever been a defendant in a civil lawsuit based on claims you committed an intentional tort such as a wrongful death, assault, battery or false imprisonment?

Yes

No

If Yes, state the date and place of the lawsuit, the court it was filed in and how it was resolved.

A criminal or civil tort record will not necessarily be a bar to employment.

Describe all computer programs you are proficient in:

Are there any other experiences, skills, qualifications, licenses or certifications which you feel would especially qualify you for work with Gulf Harbour Yacht and Country Club?

If a job description is provided, please state whether you are able to perform the essential functions listed on it, with or without reasonable accommodation.

Yes

No

Applicant Statement

1. I hereby consent to Gulf Harbour Yacht and Country Club verifying all of the information I have provided on this application form.

2. I consent and agree to taking any drug or alcohol tests as may be required by Federal or State law/regulation, as well as Gulf Harbour Yacht and Country Club’s policy. If employed, I also agree to abide by the rules and regulations, policies and procedures of Gulf Harbour Yacht and Country Club.

3. I understand that any false answers or statements, or misrepresentations by omission, made by me on this application or any related document, will be sufficient for rejection of my application or for my immediate discharge should such falsifications or misrepresentations be discovered after I am employed. Accordingly, I affirm that all information provided by me on this application is true and complete to the best of my knowledge.

4. If an employment relationship is established, I understand that the employment relationship is an at-will relationship and that I have a right to terminate my employment at any time and that the Company retains the same right. I also understand that, if hired, there will be a 60-day introductory period.

5. I further acknowledge and understand that it is my responsibility to fully complete this application form, sign and date it; otherwise, it will not be deemed by the Employer to be a valid or acceptable application. I also understand that I may supplement this application with a resume; however, a resume standing alone will not be accepted.

6. I understand and authorize Gulf Harbour Yacht and Country Club, in connection with my application for employment and hiring process, to conduct reference checks (personal and employers) and background checks (including criminal, civil, driving record, and credit).

Applicants Signature:

Date: